T-cells extracted from a tumor, expanded and then re-introduced into the body have resulted in the disappearance of tumors in a woman with metastatic breast cancer.
Research published in Nature Medicine by scientists at the National Cancer Institute (NCI) has described a new immunotherapy approach, which led to a complete disappearance of tumors in a woman with advanced metastatic breast cancer who only had months to live. The findings show how naturally-occurring tumor infiltrating lymphocytes (TILs) were extracted from the patient’s tumor, grown outside of her body to boost their numbers and injected back into the patient to tackle the cancer. The patient had previously received several treatments including hormone therapies and chemotherapy, but nothing had stopped the cancer progressing. After the treatment, all of the patient’s tumors disappeared and 22 months later, she is still in remission.
Researchers are particularly enthusiastic about the potential of TILs to treat a group of cancers termed ‘common epithelial cancers’, which include those of the colon, rectum, pancreas, breast and lung, together accounting for 90% of all deaths due to cancer in the U.S, around 540,000 people annually, most of these from metastatic disease.
In this case they isolated these lymphocytes from the tumor, grew them in large numbers and gave them back to the patient. They made around 90 billion cells for this patient. While the TILs were being grown, the patient was also treated with PD-1 blocking, immunotherapy agent Keytruda to modify the immune system so other immune cells wouldn’t interfere with the TILs when they were infused back into the patient after being greatly expanded.
They are developing patients own lymphoblasts into treatments, they are natural T-cells, not genetically engineered. This is highly personalized treatment. The metastatic breast cancer patient is not the only person to have been successfully treated using this method. Impressive results have also been obtained in an additional three different types of metastatic cancer; colorectal, bile duct and cervical. These treatments have the potential to treat patients with any cancer.
Although the results are undoubtedly promising, especially due to the low levels of toxicity patients have experienced compared to conventional chemotherapies, cancers often develop resistance to treatments and often metastases may have different mutations than the original tumor. It is ironic that the very mutations that caused the cancer may be the Achilles heel that enables the destruction of the cancer. It’s really important to treat for different mutations at once.
If larger trials support these excellent preliminary results, producing individualized T-cell therapies for each patient is undoubtedly a logistical and technical challenge, requiring specialist laboratories and expertise. How practical is it to produce a completely personalized therapy for each patient?
Indeed, several companies are already running trials for TIL therapies, including Bristol-Myers Squibb and Iovance Biotherapeutics, the latter of which specifically focuses on TILs. Clinical trials of TILs are currently underway for melanoma, cervical, lung and even notoriously hard-to-treat glioblastoma and pancreatic cancer, amongst others.
Very rarely do entirely new methods of treating cancer enter the fray with such dramatic results as those shown for TILs in these individual cases. What is needed now are the results from the underway larger scale clinical trials and continual monitoring of patients who have been successfully treated to ensure their cancers do not relapse.
I swallowed a spoon and went straight to the doctor,The doctor said “sit quietly and don’t stir